[Question #6830] Dr. Hook - HIV & HSV correlated?

12 months ago
 Hi Dr. Hook,

So I had a brief unprotected encounter with a new partner and I went for testing 3 days later and got a hsv igm positive of 1.99 and then it went to 1.64 two days later. The new partner also was tested but she was positive for hsv 1 igg but negative for everything else including hiv 4th gen.

Anyhow my doctor who is a very famous dermatologist in my country said it was a false positive and that my hsv igg would not turn positive which it didn't even at 12 weeks post incident. 

According to him he has seen HSV igm false positives in cases of hiv infections. Now I have got tested quite a few times since the incident and even got the hiv-1 qualitative test done which was negative. The last hiv 4th gen I took at 15 weeks which was also negative but my doctor thinks it may be hiv-2 so he is not saying I am conclusive as yet. 

My questions are as follows:
1. CDC mentions on their website https://wwwn.cdc.gov/hivrisk/how_know/different_tests.html that you should redo in 3 months if your first test is within 3 months. That is basically saying 6 months right? In other words what is the window period according to CDC?
2. Have you seen HSV igm false positives due to recently acquired HIV infection? 

Thanks for your time in advance. 
Best,
Edward W. Hook M.D.
Edward W. Hook M.D.
12 months ago
Call back to our forum. I’m sorry to see that you continue to worry about you’re falsely positive IgM HSV blood test. As Teri has told you the IgM test is very, very unreliable and should never be taken. On those unfortunate occasions when a IgM test got HSV is taken, if positive, the results should be ignored.  Falsely positive IgM tests are chance events which can occur due to cross reacting antibodies of many different types. There is no relationship between a falsely positive blood test and risk for HIV.  In response to your specific questions:

1.  Information on the website that you have seen is out of date. Combination HIV antigen antibody tests are entirely reliable at any time more than six weeks after an exposure. There is no need for follow-up of these tests at either three months or beyond.

2.  I do not order IgM HSV tests because they are unreliable. As pointed out to you by Terri, the CDC also specifically recommends against these HSV IgM tests. When a person with HIV has a falsely positive HSV IgM test it is a coincidence and there is no causative relationship.

Please, please do not continue to be concerned about your falsely positive test results. Ignore them. Forget about them. HIV test results taken on specimens at any time beyond six weeks are conclusive. I hope this statement is helpful. EW8
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12 months ago
Dear Dr. Hook, Thanks for replying to me. Last question and then I will be a peace. 
Do viruses react to each other or is it the antibodies of other viruses / infections / that react to the antigen.. For example if I put HIV virus and Herpes virus in a dish do they react on one another? This maybe what my doctor is thinking about...just a bit wierd for him to say specifically that I need to wait for 4 months at a bare minimum. Not sure why he is saying that. Thanks
Edward W. Hook M.D.
Edward W. Hook M.D.
12 months ago
No viruses do not interact with each other.  The act independently.  My suspicion is that your doctor is being overly conservative.  EWH
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12 months ago
Great. I think this is the final point is that i took valcyclovir 500mg twice daily for 3 weeks when I thought I had herpes. 
Does that interfere with the hiv testing?
Edward W. Hook M.D.
Edward W. Hook M.D.
12 months ago

No, valacyclovir would have no effect on your HIV test results.  The would still be entirely reliable at any time more than 6 weeks after an exposure.

As you know, we provide up to three responses for each question.  Thus this thread will be closed shortly without further responses.  I hope the information provided is helpful.  Please don't worry.  EWH

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12 months ago
Yes very helpful indeed. Thanks for your patience and understanding. 
Best,